Tea is widely thought to have health benefits, particularly on cardiovascular disease (CVD). Our group recently found that intake of 2 or more cups of tea per day was associated with a 44% lower long-term mortality rate than abstention from tea among 1900 patients hospitalized with myocardial infarction. Short-term trials support a benefit of tea on endothelial function, but long-term randomized trials of tea intake on CVD and atherosclerosis are needed to test the effects of tea definitively. [unreadable] [unreadable] We propose a proof-of-principle pilot study of the effect of long-term tea intake on atherosclerosis. From a large hospital-based primary care practice, we will recruit and randomize 30 patients at high risk for CVD to a six-month period of consumption of 3 cups per day of either tea, supplied as black tea solids readily dissolved in hot or cold liquid, or water. We will confirm the polyphenol content of these solids at baseline, and use a single batch of tea throughout the study. At baseline and after 6 months, we will assess aortic atherosclerosis using magnetic resonance imaging, an accurate and reproducible method for measurement of arterial plaque size. We will measure adherence using urinary catechins, the primary flavonoids in tea. The primary outcomes will be compliance with tea intake and 2 MRI examinations. As secondary outcomes, we will measure standard and novel cardiovascular risk markers, including inflammatory, prothrombotic, fibrinolytic, and metabolic factors. We will also assess the effects of tea consumption on oxidizability of LDL and VLDL cholesterol, using a novel affinity-column chromatography approach, on oxidative damage to DNA, and on endothelial integrity, as assessed by serum markers of endothelial function. If successful, this pilot study will form the basis for a larger, long-term randomized trial to determine the effect of tea consumption on progression of atherosclerosis. [unreadable] [unreadable]